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NPI Code Detail

MEDICARE: STEPHANIE L BESTWINA O.D.

MEDICARE:   STEPHANIE L BESTWINA  O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist3082CO
2152W00000XOptometrist2700TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15587945OTHERTNCIGNA
2243807OTHERUHC
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
44204031OTHERTNBCBS
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952396707
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE L BESTWINA O.D.
Provider Business Mailing Address
First Line : 7095 LEXINGTON DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-6329
Country : US
Telephone Number : 719-638-4010
Fax Number : 719-638-4021
Provider Business Practice Location Address
First Line : 6310 S US HIGHWAY 85-87
Second Line :
City : FOUNTAIN
State : CO
Zip : 80817-1006
Country : US
Telephone Number : 719-391-2317
Fax Number : 719-390-2947
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2005
Last Update Date : 12/17/2019

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Directions to “ STEPHANIE L BESTWINA O.D.” Practice Location

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